1Nutritional Epidemiology Observatory,Department of Social and Applied Nutrition,Institute of Nutrition Josué de Castro,Rio de Janeiro Federal University,Rio de Janeiro, 21941-590,Brazil.
4School of Social and Community Medicine,University of Bristol, Bristol BS8 1TH,UK.
Br J Nutr. 2018 Feb;119(3):320-329. doi: 10.1017/S0007114517003580. Epub 2018 Jan 18.
The aim of this study was to evaluate the association of dietary patterns (DP) with maternal adiposity indicators, leptin, adiponectin and insulin concentrations during pregnancy. A prospective cohort of pregnant women followed up at the 5th-13th, 20th -26th and 30th-36th gestational weeks and 30-40 d postpartum was conducted in Rio de Janeiro. A FFQ was administered in the third trimester (30th-36th gestational weeks). The reduced rank regression procedure was used to identify DP that explain response variables (dietary fibre and total fat) related to indicators of maternal adiposity (postpartum weight retention and gestational weight gain (GWG) adequacy), and plasma leptin, adiponectin and insulin concentrations. The associations between tertiles of DP and the outcomes were determined using logistic regression or longitudinal linear mixed-effect regression models. The mean daily energy intake during pregnancy was 10 104 (sd 3234) kJ (2415 (sd 773) kcal), and GWG was 11·9 (sd 4·2) kg. In all, 40 % of women presented pre-gestational overweight/obesity. Excessive GWG occurred in 34·7 % of pregnant women and 56·6 % were overweight/obese at postpartum. The 'common-Brazilian' DP (characterised by higher intake of beans, rice and lower intake of fast food/snacks, candies/table sugar and processed meats/bacon) was positively associated with adiponectin (β=1·07; 95 % CI 0·17, 1·98). The 'Western' DP (characterised by higher intake of fast food/snacks and processed meat/bacon and lower intake of noodles/pasta/roots/tubers and sodas) was negatively associated with adiponectin (β=-1·11; 95 % CI -2·00, -0·22) and positively associated with leptin concentrations (β=64·9; 95 % CI 22·8, 107·0) throughout pregnancy. It may be suggested that the 'common-Brazilian' is a healthy DP and beneficial for serum concentrations of adiponectin and leptin.
本研究旨在评估孕期饮食模式(DP)与母体肥胖指标、瘦素、脂联素和胰岛素浓度之间的关联。在里约热内卢对一组在第 5-13、20-26 和 30-36 孕周以及产后 30-40 d 进行随访的孕妇进行了前瞻性队列研究。在孕晚期(第 30-36 孕周)进行了 FFQ。使用降秩回归程序来识别 DP,这些 DP 可解释与母体肥胖指标(产后体重保留和妊娠期体重增加(GWG)适当性)相关的反应变量(膳食纤维和总脂肪),以及血浆瘦素、脂联素和胰岛素浓度。使用逻辑回归或纵向线性混合效应回归模型确定 DP 三分位组与结局之间的关联。孕期平均每日能量摄入量为 10104(sd3234)kJ(2415(sd773)kcal),GWG 为 11.9(sd4.2)kg。总共有 40%的女性在妊娠前超重/肥胖。34.7%的孕妇出现了 GWG 过多,56.6%的孕妇在产后超重/肥胖。“常见的巴西”DP(以摄入更多豆类、大米和更少摄入快餐/零食、糖果/食糖和加工肉类/培根为特征)与脂联素呈正相关(β=1.07;95%CI0.17,1.98)。“西方”DP(以摄入更多快餐/零食和加工肉类/培根以及更少摄入面条/面食/根茎/块茎和苏打水为特征)与脂联素呈负相关(β=-1.11;95%CI-2.00,-0.22),并在整个孕期与瘦素浓度呈正相关(β=64.9;95%CI22.8,107.0)。因此,可以认为“常见的巴西”是一种健康的 DP,有利于血清脂联素和瘦素浓度。